Why Anorexia is Just Like Gender Dysphoria...? A Conversation with Deanne Jade
Deanne Jade, founder of the National Centre for Eating Disorders, draws a striking parallel between anorexia and gender dysphoria: both can function as overvalued, socially reinforced beliefs that persist despite causing harm. For British clinicians working in the shadow of the Cass Review, her argument carries particular weight. The NHS has long refused to simply affirm an anorexic patient's distorted self-perception — yet for years the gender identity service at Tavistock did precisely that. Deanne's clinical framework asks whether thorough, patient-centred assessment could apply equally to both conditions.
Deanne Jade has spent decades treating people with eating disorders, founding what became one of Britain's most respected centres for the condition. In this conversation she brings that hard-won clinical experience to a question that is reshaping debates across the NHS and in therapy rooms throughout the UK: whether gender dysphoria shares important structural similarities with anorexia — not as an insult to either condition, but as a clinically meaningful comparison that could reshape how both are understood and treated. The thread connecting the two, in Deanne's framing, is the way certain distressing beliefs become fixed, self-reinforcing and resistant to change even when they are causing measurable harm. She describes a golden thread running through eating disorders, self-harm and gender dysphoria — behaviours amplified by social context, peer dynamics and online communities, and that can harden into what clinicians call overvalued beliefs. The individual becomes convinced of something about their body or identity that feels completely real to them, and any challenge to that conviction can seem like a fundamental attack on who they are. The concept of overvalued beliefs has a long history in eating disorder treatment, and Deanne explains how it shapes the therapeutic approach: rather than affirming the belief, clinicians work slowly and carefully to understand the person behind it. An anorexic patient who insists she is fat is not told that she is right. Nor is she shamed or dismissed. Instead, good clinical practice involves curiosity, thoroughness and patience — qualities the Cass Review explicitly called for in the assessment of young people presenting with gender dysphoria, and qualities that were in short supply at the Tavistock clinic before its closure. The parallel is uncomfortable, but it is precisely the kind of discomfort the Cass Review asked professionals to sit with. Dr Hilary Cass's findings highlighted that a significant number of young people referred to the gender identity service had co-occurring mental health difficulties, including eating disorders, anxiety and autism. Deanne's framework helps explain why those conditions might cluster together, and why an approach built primarily on affirmation — without the thorough psychological assessment that is standard in eating disorder services — may have failed many of the young people it was meant to help. Deanne is a member of Thoughtful Therapists, the UK network of clinicians committed to evidence-based, exploratory practice in this area. Her voice matters because it comes from outside the gender identity field: she is not arguing from ideology but from decades of watching similar dynamics play out with eating disorders. For therapists working under the shadow of conversion therapy legislation, and for parents trying to navigate referrals into a post-Tavistock NHS still finding its footing, her account of what careful, unhurried clinical work actually looks like is both instructive and reassuring. The episode also touches on autism, ARFID and the role of social comparison, competition and notions of purity — themes that echo the emerging evidence base around gender dysphoria in adolescent girls. Taken together, the conversation offers British listeners a clinically grounded language for a debate that too often gets stuck in ideological terrain.
